Cesarean and VBAC Archives - Informed Pregnancy Media

What is a doula?

by Eryn Shaffer Davidson | Mar 2, 2025 | Cesarean and VBAC, Labor and Delivery, Pregnancy

“Birth doulas are often described as providing educational, emotional and physical support during labor, birth and postpartum. I would also add advocacy into that mix, frequently partnered with training in trauma-informed care and anti-racism…”

What is a doula? Interestingly enough, this question can be difficult to answer directly, and for many reasons. Some would say a doula is an advocate, while others would sum up a doula’s role as “witness.” Some might describe doulas as comforting, soft, and supportive, while others might hire a doula because they want a fierce, bulldog defender or tough-loving coach.

There is also the word’s problematic origin—“doulē” which is Greek for “female servant” or “female slave”—and the fact that some people might want to take a step away from this etymology. In fact, “doulas” as we know them in the modern western world have been called many things: In ancient Greece, “maiai” (meaning “great” or “mother”) would attend births, taking on both the role of a doula and a midwife. Supporters or guides of birth might be called “birth attendants” or “wise women” in places like South America or Africa. Some doulas in North America prefer to call themselves “birth coaches” or “birth keepers.” There are many times I see my work as a doula as “companioning,” a term I borrowed from Dr. Alan D. Wolfelt’s keynote at an Association of Death Education and Counseling conference in Chicago.

And yet another element spicing up the answer to this question is the definition of a doula as a “guide through transition.” These days, we see doulas helping people through many different transitions: In addition to birth and postpartum doulas, there are death doulas, adoption doulas, abortion and loss doulas, divorce doulas, and the list goes on. As a person passionate about cycle education and empowering women to have healthier and happier periods, I’ve considered also taking on the title of “period doula.”

But I was asked to write for Dr. Berlin’s blog, which gives me the hunch that many of you are here to learn more about birth doulas and what exactly we do. Birth doulas are often described as providing educational, emotional and physical support during labor, birth and postpartum. I would also add advocacy into that mix, frequently partnered with training in trauma-informed care and anti-racism (critical elements of our work, considering over 50% of women will experience sexual violence involving physical contact in their lifetimes and BIPOC birthing people are 2-4 times more likely to die in childbirth compared to their white counterparts.)

Often we meet with parents early in their pregnancy journey (sometimes even before) and help them navigate the ins and outs of prenatal care and birth plans or preferences. As their due window approaches, we equip them with comfort measure tips, self advocacy tools, and the risks, benefits, pros and cons of any option they may consider. We are there as family-centered support, a listening and affirming ear, and a comforting, warm touch. We protect and preserve the “labor bubble” by keeping the lights dim, encouraging privacy, and mediating where needed.

Many of us are also nerds. I’ve heard it said that “OBs are surgery and high risk experts, midwives are physiological birth experts, and doulas are labor experts.” We’ve got tools in our pockets for an asynclitic baby, a sunny side up baby, a baby stuck too high in the pelvis, a stalled labor, and the oh so dreaded back labor. But don’t rush to put us in the “crunchy only” box just yet, because we’ve got other cards up our sleeves—Doulas can assist with productive epidural positions and acupressure, or help clients advocate for a family-centered cesarean birth, too.

All this said, doulaship is not a regulated profession. There are certified doulas and doulas who choose not to certify. There are doulas who choose to only attend hospital births and doulas who specialize more in physiological or out of hospital birth. There are doulas who will pray for you and doulas who will push you, and doulas who will do both! This is why it’s important to think about why you want a doula and how you see one supporting you.

Meet with 3-4 doulas and ask them prepared questions. It is important to find a doula who feels like the right fit for you—not just the one who knows the right maneuvers, but the one whose presence alone makes you feel how you want to feel as you bring your baby into the world.

And while we’re discussing what you might want in a doula, it might be important to point out a few things that doulas do not do: We do not do anything medical like take vitals or perform cervical exams. We do not replace midwives. We do not replace your partner. We cannot promise a perfect birth or a birth exactly how you planned it. And lastly but actually very importantly, we cannot have your baby for you. Instead, we strive to equip you to birth positively and confidently.

Midwife Ashley Booth Young once said “Although the popularly desired outcome is ‘healthy mother, healthy baby’, I think there is room in that equation for happy, non-traumatized, empowered and elated mother and baby.” And I think that encapsulates the united goal of doulas beautifully.

Need some questions to ask potential doulas? Here are a few to help get you started:

1. What got you into birth work and why do you do what you do?

2. Do you work with a back-up in case you can’t attend my birth, and can I meet them ahead of time?

3. I’m particularly nervous about ____ happening. Can you walk me through how you would support us if it were to happen?

4. What do your services include?

5. How would you describe your practice in one (or three) words?

About the author: Eryn Shaffer Davidson is a doula based in Waco, Texas. She is certified through Carriage House Birth and is also training to become a childbirth educator with Evidence Based Birth. Beyond birth work, she is passionate about empowering women through the entirety of their reproductive journeys, and could go on for too long about how periods shouldn’t hurt and how contraceptive options extend far beyond the pill.

An avid Informed Pregnancy Podcast listener, she is driven by the desire to see women fear birth less, and instead experience joy, support and clarity in their bodies and their choices. She dreams of a world where the evidence-practice gap is a little smaller, and collaboration between home birth and hospital providers is the norm. When she’s not at a birth, you can find her working with production company Stork Films, reading the latest Evidence Based Birth article, detoxing in a hot yoga class, or watching Grey’s Anatomy (seasons 1-8 only.)

www.eryndavidsondoula.com

All photos courtesy of Eryn Shaffer Davidson

Birth of a Doula Pt 2 of 2

by Hannah Gill | Mar 1, 2023 | Cesarean and VBAC, Labor and Delivery

“Ten minutes and a few contractions passed and Julie asked if I would feel comfortable moving to the squat bar. In my head, I thought she was crazy. There was no way I could support my body in a squat but with help from Scott, Julie, and our nurse, I repositioned and it was the best decision I made.”

My second birth experience was as different from my first as night is from day, both physically and mentally. I spent over a year preparing, I hired a doula, and I healed from the trauma of my first birth. Therapy helped tremendously in working through my postpartum depression, postpartum anxiety, and birth trauma. Simply having my experience and feelings validated lifted weight from my chest. Fear releasing and hypnosis practice also helped me prepare my mind. I knew it would be necessary to forgive myself and be at peace with my cesarean before I could fully surrender to birth again.

I woke up at 40+2 weeks with heavy bleeding. After talking to my husband, doula, and OB, I decided to head to triage for monitoring. Upon arrival, I was 3cm dilated and having irregular, unnoticeable contractions. My OB wanted to see if the bleeding was caused by a placental abruption or an intense bloody show. Luckily baby and I were both in stable condition and the bleeding eventually stopped. We had planned to return home because I wanted to labor there as long as possible but I had already dilated another centimeter and my contractions started to become more regular, so we stayed.

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Once admitted, I got my first round of IV antibiotics since I was positive for Group B Strep. My contractions quickly grew in intensity and frequency and my water broke as I dilated to 5cm. While I was still in the right mindset, I sent a quick text to my doula, telling her to head to the hospital. At this point, I felt that I had to go to the bathroom. Laboring on the toilet felt like the most natural position to be in and after 45 minutes it was clear that I was transitioning. I began shaking and sweating as Scott massaged my shoulders and used a wet washcloth to cool me down. Out of breath, I told him I wanted an epidural but he knew how badly I wanted to stay unmedicated and encouraged me to wait for Julie to arrive for support.

When Julie finally walked into the bathroom I immediately told her I needed an epidural but thankfully, she suggested a position change instead. I moved to the shower and hung around Scott’s neck as Julie sprayed warm water onto my back. I felt the need to bear down as my body instinctively pushed. Julie suggested I go to the bed and get on my hands and knees. Still pushing, I positioned myself on hands and knees, holding onto the incline of the bed. It was a relief to be able to rest my head between contractions. Ten minutes and a few contractions passed and Julie asked if I would feel comfortable moving to the squat bar. In my head, I thought she was crazy. There was no way I could support my body in a squat but with help from Scott, Julie, and our nurse, I repositioned and it was the best decision I made.

In five intense minutes, our daughter was born, just under five hours from the first contraction I

felt. She came down and through the birth canal so quickly, there was no time for head molding so her head was perfectly round. Every bit of pressure and discomfort I felt disappeared as I pulled her to my chest with tears of pure bliss streaming down my face. I had done it. I had the unmedicated VBAC I so badly wanted and it was the most rewarding and beautiful thing I have ever done.

After the pregnancy and birth experience I had and the relationship I developed with my doula Julie, I knew I had to become a doula too. Through training I was able to experience birth from a completely different perspective, one that opened my eyes to how unique each person’s experience is. So now, not only can I help educate women on their options in pregnancy, birth, and postpartum, but I can also help support them as a doula during labor.

Many people may be shocked to hear that I am thankful for the way both of my births unfolded. Although extremely difficult, my first birth brought me my son and a learning experience about taking charge of my health choices. My second birth brought me my daughter and helped me find the strength and power I have as a woman and a mother. Both experiences together lit a fire for a passion inside of me that I never knew existed.

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Hannah Gill is a VBAC mom of two, birth and postpartum doula, birth educator, and owner of Ebb and Flow Birth Co. She has a passion for helping support women through cesarean and VBAC births and throughout the postpartum period. She believes women deserve to be respected and supported in their pregnancy, birth, and parenting choices. You can find out more about Hannah and her services at ebbandflowbirthco.com and over on Instagram@ebbandflowbirthco.

Birth of a Doula Pt 1 of 2

by Hannah Gill | Feb 22, 2023 | Cesarean and VBAC, Labor and Delivery

“The anesthesiologist gave me something for the pain and whatever it was, I began to doze off. The next thing I remember was hearing my husband Scott say, “Babe it’s a boy!””

Going into my first pregnancy, I thought I was doing all the “right things” to prepare. I read all the books and blogs, took a hospital childbirth course, and played twenty questions with my OBGYN. The majority of my work experience at that point was in healthcare, so I favored a medicalized approach. I simply followed the mainstream checklist of what you should do for birth, unaware of all the options I actually had.

My pregnancy was rough and I spent the majority of the 40 weeks vomiting but still somehow gained sixty pounds. The only other “complication” was gestational thrombocytopenia which meant there was potential I would risk out of epidural criteria. As the end of my third trimester approached, I was ecstatic to finally meet my baby, not knowing that birth and postpartum would shatter my entire being and make way for a rebirth I never saw coming.

My labor plan was to be unmedicated and at the time and I felt more prepared than ever. It wasn’t until five weeks postpartum from a traumatic cesarean, drowning in breastmilk and feelings of failure, that I realized how unprepared I truly had been. To put it simply, I was naïve. The notion that I could end up with a cesarean never even crossed my mind because I thought, “That only happens in emergencies which only happen to people with unhealthy or complicated pregnancies.” I’m pretty sure I glossed over that entire section in my birth education workbook.

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When labor began, I panicked. My contractions started out extremely intense and were only 5-7

minutes apart. That was not the gradual build-up I had read about. I was immediately anxious and overwhelmed. As soon as I got to the hospital and got the okay for my platelet levels, I asked for an epidural. I was disappointed that I gave in so quickly but the disappointment faded as my body relaxed and I was able to rest. The epidural was so strong I couldn’t even feel pelvic pressure and after four hours of pushing, I opted for a cesarean. I was speechless, trying to hold myself together while my mom cried and kissed my forehead. I had no idea what my body and mind were about to go through.

Surgery started and immediately I felt more than “just some pressure,” as they had described. I was in full-blown pain. The anesthesiologist gave me something for the pain and whatever it was, I began to doze off. The next thing I remember was hearing my husband Scott say, “Babe it’s a boy!”. I don’t remember my son Hudson’s first cry or meeting him for the first time. I spent the next few hours in the recovery room hypotensive and on the verge of passing out from postpartum hemorrhage. I was unable to hold Hudson but Scott helped him latch and feed while the nurses worked to stabilize me.

During the transfer to the postpartum ward Scott went home to shower so it was just me, Hudson, and my dad. Switching beds is the moment I remember more vividly than any other. I was flat on my back, looking up at the ceiling as they began to move me. Counting to three, they slid me over from one bed to another and I let out a scream I never want to hear myself make again. As tears poured down my face and I tried to catch my breath, I noticed my dad out of the corner of my eye. He was facing away from me – his hand on Hudson’s bassinet – wiping away his own tears. I had never felt so scared and out of control in my entire life. It was at that moment I knew I could never go through this again.

Shortly after, I began to research what had gone wrong and specifically, what I had done wrong. I felt that my body had failed me and my baby. Soon though, I realized it wasn’t my fault. I made the best decisions I could with the information I had but I didn’t know what I didn’t know. Ultimately, this process helped me plan for a vaginal birth after cesarean (VBAC) and start my journey to become a childbirth educator. My goal became to create a birth course that truly gave people information about all of their choices when it comes to pregnancy, birth, and postpartum.

…Stay tuned for Part 2 coming next week!

Check out Hannah’s episode of The Informed Pregnancy Podcast!

A Second Chance and a New Beginning

by Kate Eales | Nov 1, 2022 | Cesarean and VBAC, Labor and Delivery

**This is a repost of a classic Informed Pregnancy article.

“During those final days, though, Dr. Schneider asked me one question that gave me pause: Why did I want a VBAC so much? Even after all I’d done to try for a successful VBAC, it was a difficult question to answer. For me, having a VBAC certainly didn’t matter more than having a healthy child.”

My VBAC journey began, as many do, with an unwanted cesarean.

It wasn’t that the labor and delivery of my first child were terribly traumatic. But for five hours after my son’s birth – time I had hoped to spend bonding with my new baby – I was alone in a recovery room, my sense of failure growing by the minute. All of the messages of empowerment that I’d received before labor now haunted me instead: Women are built for natural childbirth. Your body knows what to do. You and your baby will work together to make it happen. What did it mean about me as a woman, and as a mother, that I hadn’t done it? I worried that I’d never be able to breastfeed, that my baby and I would never bond, that I had failed him in his first moments of life.

These worries faded as we met, and bonded, and breastfed without trouble, but the seeds of doubt about my birth experience had been sown deep. Was it my fault for getting an epidural at 4cm? Had I not been moving enough in labor? Had the clock really run out, or was my midwife (who’d been at the hospital for four straight days with deliveries) just exhausted?

During my second pregnancy, I resolved to do as much as I could to avoid feeling so much self-judgment and doubt after the baby’s arrival. I ruled out a home birth, just as I had the first time, but I knew that the first change to make was also the most important: I needed a new care provider whose opinion and experience I trusted completely. I was thrilled when I found Dr. Jessica Schneider, partly because I knew she was supportive of VBAC, and partly because our communication was so open and easy. I remember coming home from one of our first appointments and saying to my husband, “I’m going for a vaginal birth, but whatever happens, I know I’m in good hands. If she says I need a cesarean, I’ll trust her.”

As my pregnancy progressed, I did everything that I felt comfortable doing to increase my odds of VBAC success. I found a wonderful doula, took hypnobirthing and VBAC prep classes, and started regular acupuncture and chiropractic visits. At every ultrasound, I was told that my daughter was measuring big, but my doctor assured me that we could still try for a VBAC. As I sailed past weeks 37, 38, and 39, I took steps at home to avoid an induction, which I knew counter-indicated VBAC success. Herbal teas, nipple stimulation, scrubbing the floor, sex… I tried them all. I remained hopeful for a long time, but as I passed 40 weeks with no sign that labor was near, I realized I was starting to panic. My first baby had been late, and big, and arrived via cesarean, and here I was, past my due date again, with another big baby… I shared my mounting anxieties with Dr. Schneider and she assured me that yes, we could still try. The decision to go for a VBAC was going to stay in my hands.

During those final days, though, Dr. Schneider asked me one question that gave me pause: Why did I want a VBAC so much? Even after all I’d done to try for a successful VBAC, it was a difficult question to answer. For me, having a VBAC certainly didn’t matter more than having a healthy child. Sitting inside that exam room, it was incredibly hard to say out loud that I worried I would feel like less of a woman if I never had a vaginal birth. Hearing myself say it, I knew it was absurd – but once I said it, I cried, and that emotional release felt better than anything else I’d done in the preceding few weeks. After that cathartic moment of letting go, I decided to schedule my induction, and I stopped scrubbing the floor at home. Labor would start before my induction, or it wouldn’t. I spent those last few days relaxing.

At the end of my 42nd week, I went in for my induction. I had a mental list of targets for my labor and delivery, and to my joy, everything starting humming along as I’d hoped. After an initial small dose of Pitocin, I labored naturally for hours, and this experience was completely different from my first. At 8cm, I asked for a walking epidural, after which I was able to keep moving: squatting, doing yoga, resting, and then moving again, doing everything I could to make my baby come down.

As it turned out, my baby was not coming down. About 24 hours after my induction began, my dilation had stalled and the baby had been stuck at zero station for several hours. Dr. Schneider came in and gently said, “I think it’s time to talk about a c-section.”

And there we were. I won’t deny that I was disappointed. But once my husband and I were alone, discussing our options, we both came back to what I’d said before about trusting Dr. Schneider. She was leaving the door open for me to wait if I wanted to, but she didn’t advise it, or think it would help. What would I be fighting for if I said no, and for how long?

My mantra for labor (and the name of at least three tracks on my music playlist!) was “Let Go.” It felt clear to me now that the best way for me to bring my daughter into the world was to let go of my vision for how it would happen.

That is how my VBAC journey came to end with a repeat cesarean. But this time, after my (healthy, 10-pound!) daughter was born, my doctor made sure we weren’t separated at all. I held her and nursed her in recovery, and in the days that followed, our bonding and my recovery went beautifully.

Before we said yes to the second cesarean, my husband and I talked about how having another cesarean would mean leaving certain questions unanswered forever. Would our daughter have come down if I’d kept on squatting and walking for a few more hours? Maybe. Might I have had a VBAC if I’d had a home birth? Perhaps. Was there anything I could have done differently to end with the VBAC I’d hoped for? It’s possible. But in leaving these “what if” scenarios unanswered, I feel peace knowing there’s another question that will remain unanswered: what if I will never know how lucky I am that cesareans exist? No matter the answers, I feel okay with not knowing.

One thing I do know is that in no way am I less of a woman, or less of a mother, because I birthed my son and daughter via cesarean. And while I believe that “healthy baby, healthy mother” comes first, I know that they are not the only things that matter. It turns out that it mattered to feel that my birth “experience,” not just the statistical outcome, were important to my care team, and it mattered that I felt good about myself when all was said and done. I do feel good about myself. My second cesarean turned out to be a second chance, and I have no regrets about my choice to let go.

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Kate Eales was born in Minneapolis, Minnesota, USA. She is a prenatal yoga teacher and feature film editor.